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Medicare Supplement Insurance (Medigap): What It Is and How It Works

Female senior citizen reading something on her phone about Medicare.

Original Medicare covers a wide range of healthcare services, but it doesn’t pay for everything. Deductibles, copayments, and coinsurance can add up significantly over time, especially for people who use medical services frequently. That’s where Medicare Supplement Insurance — commonly known as Medigap — comes in.

What Is Medigap?

Medigap is private health insurance designed specifically to fill in some of the cost gaps left by Original Medicare (Parts A and B). These policies help pay for things like the Part A hospital deductible, Part B coinsurance, and, in some cases, coverage for medical care when traveling outside the United States.

Medigap policies are sold by private insurance companies and are standardized by the federal government in most states. This means that a plan with a particular letter designation — Plan G, for example — offers the same core benefits regardless of which insurance company sells it. Premiums, however, can vary significantly between companies.

What Medigap Does Not Cover

It’s important to understand that Medigap is not the same as Medicare Advantage. Medigap supplements Original Medicare — it does not replace it. Medigap policies generally do not cover prescription drugs (that requires a Part D plan), dental, vision, hearing, or long-term care.

When Can You Buy Medigap?

The best time to purchase a Medigap policy is during your Medigap Open Enrollment Period — a six-month window that begins the month you turn 65 and are enrolled in Medicare Part B. During this window, insurance companies cannot deny you coverage or charge you higher premiums based on pre-existing health conditions. Outside of this window, your ability to enroll and the costs you’re offered can vary based on your health status and state regulations.

Comparing Your Options

Because Medigap premiums vary widely between insurers for the same coverage, comparing plans is an important step. An independent insurance agent can help you understand which plan designations are available in your area and provide a side-by-side comparison of premium costs from multiple companies.

We’re Here to Help

Medicare decisions can feel complicated, but you don’t have to navigate them alone. A For The People Insurance Agency, Inc. can help you explore Medigap options and find coverage that fits your healthcare needs and your retirement budget. Call us at (412) 621-5581 or connect with us through our website.

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